Increasing Capabilities Through Coalitions 

Editorial by Clay E. Simpson, Jr., MSPH, PhD


Deputy Assistant Secretary for Minority Health


Closing the Gap, Looking for Money • April 1998


We need minority health coalitions because quite simply: 

united we stand and divided we fall. History has shown 

us this. It’s no coincidence that the term coalition comes 

out of political science, with connotations of enhancing power. Sometimes we see the most curious alliances coming together when there is 

a common goal. 

In political coalitions, we see people—sometimes rivals—coming 

together to win, where alone they would be certain to lose. This same 

approach can be an effective way to obtain funding support for minority health programs. A proposal can be made even stronger when 

there is evidence of groups banding together to increase awareness, 

improve access to services, and affect change. Alone, they would be 

fragmented and more likely to be ineffectual. Good coalitions work 

because together, we can do more, be more, serve more, and accomplish more. 

It makes sense that we approach minority health together. All of 

us are touched by the disproportionate burden of death and disability 

in our communities. We all have to worry about heart disease, the 

leading cause of death for all racial and ethnic groups. We all have to 

worry about diabetes and high blood pressure, major chronic diseases 

that are a greater burden for us. Our high rates of amputation and 

kidney disease prove it. And we all have to worry about our children, 

who are more likely than white children to die before their first birthday. 

The federal Office of Minority Health (OMH) has a small staff 

and a relatively small budget. No matter how optimistic we are, we 

know we cannot solve all of the nation’s health problems. So we 

learned a long time ago about the fruits of coalition building. 

From day one, a major OMH role has been to stimulate the nonfederal sector to carry out innovative models to improve minority health. 

So the notion of coalitions was selected as a way to maximize resources. 

And in minority communities, we know we’re often talking about 

scarce resources. 

Our minority community health coalition demonstration grant 

program grew out of OMH’s history and mission: to improve minority health, to help minority communities with capacity building, and 

to support the efforts of minority community-based organizations. 

Through the grant program, minority community health coalitions 

are able to bring together churches, health centers, private physicians, 

and others to change their communities. 

We talk about the aspects of a successful coalition in terms of the 

three Cs—commitment, clarity, and competition. The successful coalitions that we fund understand that they need to keep operating, 

with or without OMH. And they also know that they can’t take the 

chance of putting all of their eggs in one basket. So they build up 

support from all kinds of sources, public and private, which demonstrates a high level of commitment. It is crucial that all coalition 

members are committed, not only to obtaining funding, but to making the coalition work. This means that everyone, especially the people 

of authority, buy into the coalition. Coalitions don’t need figureheads, 

but rather working partners. 

Clarity in a coalition is needed early on, and has a significant 

impact on funding. From the beginning, a coalition’s mission and 

purpose need to be defined. Even the most well-intentioned coalitions can fall apart if members stray away from the original mission 

without analyzing the consequences of doing so. The survival of 

community-based organizations often dictates pursuing new objectives in order to obtain needed funding. For example, questions 

around whether to remain a single-issue or multi-issue coalition are 

critical junctures for coalitions. Using the mission and purpose as a 

framework, a successful coalition has goals and measurable and timespecific objectives. All of this, of course, calls for clarity in decisionmaking. Many coalitions grow out of temporary arrangements that 

initially operate on the consensus model. As federal funding is introduced, responsibilities and decision-making need to become more 

formalized. So coalitions need a way to make timely decisions, to 

delegate authority, and to agree and disagree. 

Competition is a fact of life. Agency and personal rivalries are a 

fact of life. We would be fooling ourselves if we thought otherwise. 

Competition is manifested in so many minority communities because 

what often happens is that those with the least are pitted against each 

other, all fighting for the same pie. But we know this only leaves each 

group with crumbs. The successful coalitions are able to confront this 

dynamic head on, and they come out stronger for holding to a united 

front and advancing their common purpose. 

I encourage you to contact our Office of Minority Health Resource Center. Information specialists are available to conduct a customized funding search for you. Call 1-800-444-6472.

Office of Minority Health Resource Center U.S. Department of Health and Human Services